Māori men at 70% increased risk of dying of prostate cancer

Māori men at 70% increased risk
of dying of prostate cancer than non-Māori
men

Graeme Woodside, Chief Executive Officer of
the Prostate Cancer Foundation of New Zealand says, “New
Zealand has significant disparities in survival for Māori
men living with prostate cancer. As a community, it is
absolutely critical we support and empower clinicians and
Māori men themselves to actively manage their health and
seek early diagnosis of prostate cancer in order to reduce
the mortality rate”.

A recent report of the Midlands
Prostate Cancer Study conducted by University of Auckland
(UniServices) and co-funded by the Health Research Council
and Ministry of Health identified that there are
approximately 3,000 men diagnosed with prostate cancer in
New Zealand every year and Māori men are 72% more likely to
die of prostate cancer once diagnosed than their non-Māori
counterparts.

Principal investigator Professor Ross
Lawrenson reports that Māori men are less likely to be
diagnosed with prostate cancer than non-Māori men, but when
diagnosed are twice as likely to have metastatic disease.
Survival at 2 years for men diagnosed with metastatic
disease is less than 40% and almost all these men have died
from their cancer.

The statistics highlight significant
inequities in New Zealand’s healthcare system between
Māori and non-Maori men with regard to prostate cancer
screening, diagnosis, treatment and health
outcomes.

“Not only are Māori men being diagnosed too
late, when their cancer is in an advanced stage, but the
management and treatment of their prostate cancer is
significantly different than that provided to non-Māori
men,” says Professor Lawrenson.

“More work has to be
conducted to inform and improve the pathways of care for men
with prostate cancer. We need to make primary care
practitioners aware of the inequities in access to screening
between Māori and non-Māori men. Further research is also
required to identify causes of the higher prostate cancer
mortality rate for Māori men compared to non-Māori men,”
added Professor Lawrenson.

It is more likely that Māori
men are treated by orchidectomy (surgical removal of the
testicles to stop most of the body's production of
testosterone – required for cancer growth). They are also
more likely to receive androgen deprivation treatment (ADT)
than non-Māori men.

Whilst New Zealand has no national
guidelines for the treatment of metastatic prostate cancer,
European guidelines recommend first line therapy after PSA
progression is Androgen Deprivation Therapy (ADT) as
standard of care. Second line therapies include docetaxel,
cabazitaxel[a], abiraterone[b]
and enzalutamide [a].

“These more
advanced treatments may provide Māori men with the
opportunity to extend their life and enjoy a greater quality
of life for their remaining time with whānau and be treated
in the community or at home,” says Mr Woodside.

“Our
Māori men deserve a higher priority when it comes to
treatment options and access to advanced treatments for
metastatic prostate cancer. Equity in the healthcare system
is well overdue,” adds Mr Woodside.

[a]
Not registered in New Zealand[b]
Registered, however still being considered by PHARMAC for
funding in New Zealand

PROSTATE CANCER IN NEW
ZEALAND:• In New Zealand, prostate cancer is
the most common cancer in men and the third most common
cause of cancer death in men after lung cancer and bowel
cancer.• Approximately 3,000 new cases of prostate
cancer are diagnosed each year.• One in 13 men will
develop prostate cancer before the age of
75.• Approximately 600 men die from metastatic
prostate cancer each year.• Mãori men are 72 per cent
more likely to die of prostate cancer once diagnosed than
non-Mãori men.• Between 10 and 20% of men with
prostate cancer progress to advanced (metastatic) prostate
cancer within 5 years of diagnosis.• 20% of men witih
metastatic prostate cancer do not receive Androgen
Deprivation Therapy within their first year of
diagnosis.

About Prostate Cancer Foundation of New
Zealand:Our mission: To provide an environment
empowering men to make informed decisions about the
diagnosis and treatment of prostate cancer. Throughout New
Zealand, we offer peer support to men, and their families,
who have been diagnosed with prostate cancer. We actively
promote awareness of this disease through community
education campaigns, and we support medical research into
improved diagnosis and treatment outcomes. For more
information visit www.prostate.org.nz or call 0800 4
PROSTATE

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